Individual provider Active NPI

Kenneth Edward Plank, O.D.

  • Optometrist
  • Oklahoma City, OK
National Provider Identifier
1275634602
Registry record updated May 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2023 Issued in OK
Practice address
9648 N May Ave
Oklahoma City, OK 73120-2714
Phone
(405) 749-2002
Fax
(405) 748-5704
NPI assigned
Sep 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2023 OK Primary

Addresses

Primary practice location

9648 N May Ave
Oklahoma City, OK 73120-2714

Mailing address

9648 N May Ave
Oklahoma City, OK 73120-2714
Phone (405) 749-2002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100113000143 OK Practitioner - Optometry 4183765142 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1990
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

9648 N May Ave
Oklahoma City, OK 73120-2714
Phone (405) 749-2002

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery24

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2023OKMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Visual-Eyes 2 PLLC Optometrist CurrentSince Nov 23, 2009 Accepting new patients

Locations

9648 N May Ave
Oklahoma City, OK 73120
Phone (405) 749-2002

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273795200000",
    "number": "1275634602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9648 N MAY AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731202714",
            "telephone_number": "405-749-2002",
            "fax_number": "405-748-5704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9648 N MAY AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731202714",
            "telephone_number": "405-749-2002",
            "fax_number": "405-748-5704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLANK",
        "first_name": "KENNETH",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2010-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.